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Hospital Safety Improves for Heart Patients, Study Finds

Hospital Safety Improves for Heart Patients, Study Finds

01/22/14

WEDNESDAY, Jan. 22, 2014 (HealthDay News) -- Efforts to reduce
"adverse events" that occur in the hospital appear to be taking
hold for patients who've had a heart attack or those being treated
for congestive heart failure, according to new research.

Adverse events include reactions to certain drugs, falls,
bedsores, hospital-acquired infections, and complications that
occur after a procedure or surgery.

Over the past decade, reducing the rate of such in-hospital
events has become a priority, and this study shows progress.
Between 2005 and 2011, the rate dropped 25 percent and 28 percent
for heart attack and congestive heart failure patients,
respectively.

But, the news wasn't as good for people hospitalized with
pneumonia or surgical patients. The overall rate of adverse events
stayed the same between 2005 and 2011 for those groups.

"There's been a lot of attention focused on patient safety, and this paper shows that some of these problems are getting better," said Noel Eldridge, a study co-author and public health specialist at the Agency for Healthcare Research and Quality. "When you look at all four groups together, the adverse event rate was going down by 4.7 percent a year. But, while things are definitely getting better, this problem isn't solved yet."

Results of the study are published in the Jan. 23 issue of the
New England Journal of Medicine.

The study used data from the Medicare Patient Safety Monitoring
System, which included information on nearly 62,000 patients who
were hospitalized for one of four reasons: heart attack, congestive
heart failure, pneumonia or surgery. The system looks for 21
different adverse events.

The data were collected between 2005 and 2011, with the
exception of 2008.

For heart attack patients, the rate of adverse events dropped
from 5 percent to 3.7 percent during the study time frame,
researchers reported. The proportion of heart attack patients with
one or more adverse events also declined, from 26 percent to just
over 19 percent.

Among congestive heart failure patients, the rate of adverse
events dropped from 3.7 percent to 2.7 percent. The proportion of
congestive heart failure patients with one or more adverse events
went down from 17.5 percent to about 14 percent, according to the
study.

The researchers found no significant differences in the overall
rates of adverse events for pneumonia and surgery patients.

However, that doesn't mean the news was all bad for those
patients. Pneumonia and surgical patients saw some improvements in
adverse drug events and in certain hospital-acquired
infections.

And, conversely, the news wasn't all good for heart attack and
congestive heart failure patients, the report indicated.

The percentage of patients developing bedsores or
ventilator-assisted pneumonia increased in heart attack patients
from 2005 to 2011. Rates of kidney problems linked to the contrast
material used in heart procedures also increased in heart attack
patients. And, in congestive heart failure patients, mechanical
problems related to central catheters increased in the study
period.

"Health care providers are working very hard to make a difference and this study shows we have made a difference," said Dr. Linda Ellis, an associate professor of medical sciences at the Quinnipiac University School of Medicine in North Haven, Conn. "Certainly, more improvements can be made, but we're working on it," she added.

Ellis said it's hard to tease out why the heart patients
appeared to improve overall while the pneumonia and surgical
patients didn't. "All of these measures of adverse events that
they're looking at can have a lot of variables," she noted. "There
could be differences from hospital to hospital. There are so many
things that affect patient safety that it's not easy to pinpoint
and focus on one factor."

But, Ellis added that "communication between providers can make
a big difference in patient safety. Teamwork is huge."

Study author Eldridge said it's hard to know from the current
data what accounts for the improvement in heart patient safety.

"We really need to dive into the data to see what made a difference," Eldridge said. "We need to dissect what happened with the different types of adverse events. Sometimes, when you look at the whole picture, it may hide improvements and successes in some areas," he explained.

Both Eldridge and Ellis noted that the good news from this study
is that there has been progress in improving patient safety, and
that patient safety continues to be a focus for health care
providers.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.